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The prospect of employment in a rapidly expanding industrial economy brought millions of immigrants from Europe, Asia, and Latin America to the brink of America in the period 1891 to 1930. This was also a period of intense social, economic, and political anxiety in the United States. Growing social and economic pressures posed by industrialization, sprawling urban cities, violent labor uprisings, economic depression, fears of middle-class "race suicide," the changing structure of American authority, and a fractured sense of American unity all fueled growing nativist sentiment in the United States. The nation was gripped in the beginnings of an effort to contain a growing sense of disorder, a sense that immigrants, garbage, unionism, corruption, and vice were all exceeding the bounds of their containment and that those bounds must be reestablished. In New York City, in 1890, Jacob Riis published How the Other Half Lives-a photo documentary of ghetto conditions that would have national impact. The following year, Josiah Strong pointed out that "a mighty emergency is upon us."
A number of national movements sought to contain a growing sense of disorder. The immigration restriction movement-lead by the Immigration Restriction League founded in 1894-attempted to stem the tide of the new immigration. By 1900 immigration from southern and eastern Europe-Italy, Poland, Russia, Czechoslovakia, Austria-Hungary-had well surpassed that from the familiar northern and western European countries. These new immigrants differed in appearance, cuisine, language, and worship; to many, they seemed dirty, illiterate, and poverty-stricken. With the immigration law of 1891, the federal government took complete authority over immigration and created the machinery for federal officials to inspect and exclude immigrants. The law required medical officers of the Public Health Service (PHS) to inspect and issue a medical certificate to all immigrants suffering from a "loathsome or a dangerous contagious disease," representing an elaboration on the formulation of what made a good industrial citizen: one who would remain healthy and not become dependent on the charity of the nation. By 1903, the PHS began to formally classify diseases in accordance with the law and, significantly, with national industrial expectations. In addition to loathsome and dangerous contagious diseases, which the PHS labeled Class A conditions mandating exclusion, the PHS created a new category of Class B diseases or conditions-those rendering the immigrant "likely to become a public charge." The unfortunate immigrant suffering from hernia, heart disease, and deformities was, as a consequence, now vulnerable to medical certification and exclusion. But not only Class B conditions affecting ability to earn a living but also the loathsome and dangerous contagious diseases took on economic meaning in the hands of the PHS.
Yet the federal attempt to control immigration represented not so much an attempt to restrict immigration, but rather to control it. Specifically, the immigrant medical inspection represented a means not only of weeding out immigrants who would not serve as suitable "cogs" in America's industrial machinery, but also of disciplining the work class by imparting the values and expectations of industrial production to the newly arriving immigrant. In this respect, it was of a piece with a host of social movements-many spearheaded by women-that sought to reestablish order beginning in the mid-1880s and growing in the 1890s. For example, Stanton Coit established the nation's first settlement house on the Lower East Side in 1886. Perhaps the nation's most renowned settlement house was Jane Adams's Hull House, opened in Chicago in 1889. New York City boasted 18 settlement houses by 1897, which sought to help immigrants adapt to life in the US and adopt American standards and values. After World War I and the beginnings of immigration restriction in 1921, the social forces driving the settlement house movement began to wan. Other social movements, such as the temperance crusade, gained momentum in the 1890s.
Social and physical upheaval intersected in New York City. The City's bounds were changing. The change from horse-driven to electrified streetcars in 1894 opened up the city in new ways and allowed for the vast expansion of Brooklyn and other parts of the city after the merger of the five boroughs in 1898, but it also stimulated strikes as the drivers protested the new schedules to which they would have to adhere. The consolidation of the five boroughs once again created an enormous need for potable water, for it created a city of some 3.5 million people. Municipal reform during this period strengthened centralized control of water and helped to place the problem of garbage to the forefront.
David H. Bennett, The Party of Fear: From Nativist Movements to the
New Right in American History (New York: Vintage Books, 1990); Richard
Hofstadter, The Age of Reform (New York: Vintage books, 1955); John
Higham, Strangers in the Land: Patterns of American Nativism 1850-1925
(New York: Antheneum, 1967); and Robert Wiebe, The Search for Order,
1877-1920 (New York: Hill and Wang, 1967); David C. Hammack, Power and
Society: Greater New York at the Turn of the Century (New York: Russell
Sage Foundation, 1982):109-111. See also Schultz and McShane, To Engineer
the Metropolis, p. 39; Josiah Strong, Our Country: Its Possible Future
and Its Present Crisis (New York, 1891); Martin Meosi, The Sanitary
City (Baltimore, 2000).