Origins of public health at Ellis Island

The crowded hospital is overflowing with hundreds of patients every day, as a small, harried staff copes with pregnancies, critically ill patients, mentally ill people and children in varying states of distress. They come from all corners of the world, and the trick is to treat them quickly -- to make way for the next arrivals.

“It is by no means unusual to receive 100 cases or more at this hospital in one day,” writes one journalist, astonished by the scene. “The task of admitting, examining, treating and housing the number of new patients five or six hours would tax the capacity of the largest hospitals in the country. And here the problem is complicated by the fact that practically none of the patients speak English.”

It sounds like the frantic emergency room of a modern hospital, but the year was 1915 and the place was Ellis Island, where a general hospital had been set up to screen the millions of immigrants pouring into America’s gateway in New York harbor.

This week, that history will come back to life in “Future in the Balance: Immigrants, Public Health and Ellis Island’s Hospitals,” an exhibit in the just-opened Ferry Building, the latest phase in a planned restoration of all the buildings on the island.

The hospital structures, which have not yet been restored, lie south of the Ferry Building. After immigrants got off the large steamers that brought them to Ellis Island, most would assemble in the Great Hall on the northern side, where they were either cleared for processing or sent to the hospital complex for further examination.

Packed with photographs, historical objects and commentary, the exhibit in the Ferry Building showcases the role these facilities played in stimulating the growth of public health policy in the United States. A largely unknown outpost of modern medicine, Ellis Island gave Americans an early glimpse of the maladies and infirmities that the melting pot would present.

“Most people think of immigration when they think about Ellis Island, but it has many other stories that are largely untold, like those about the hospital,” said Judith McAlpin, president of Save Ellis Island Inc., a nonprofit group working with the National Park Service to restore the 27.5-acre site near the Statue of Liberty.

Although the island’s main hall reopened as a museum in 1990, there is much work to be done on the remaining structures; most are in disrepair and look much like they did 100 years ago. A national fundraising campaign to fully restore the site is expected to begin this fall, and although master plans are still being developed, sponsors estimate the cost could be $250 million.

The hospital complex in particular is a ghostly reminder of the island at a time when it was processing nearly 1 million arrivals a year. Today, there are cracked and peeling walls, damaged roofs, shattered windows, stained floors and cold, empty hallways where there was once a human whirlwind.

At its height, the hospital had 16 contagious disease wards, six infectious disease wards, plus a general complex with operating rooms and other facilities. The staff included 12 doctors, plus hundreds of nurses and many others working in kitchens, laundry rooms and a library, according to Dorothy Hartman, director of education and special programs for the Save Ellis Island foundation.

“This was a major, 750-bed hospital, the largest and most advanced of its kind at the time, and it was the beginnings of an attempt to deal with public health concerns,” said the foundation’s McAlpin.

Ellis Island, which was the nation’s main portal for immigration from 1892 until it closed in 1954, processed more than 12 million new arrivals. Large numbers came from Italy, Eastern Europe and Russia, Sweden, Ireland and Great Britain; there were ample numbers from other countries as well. Typically, the travelers spent 5 to 6 hours on the small island, undergoing inspections, before heading out to their new homes. But they could not begin the journey until they were medically cleared.

The exhibit opening Tuesday tells the story of the hospital complex, which grew as the number of immigrants began swelling after the turn of the century. At the time, the facility amazed one visitor after another. It is “at once a maternity home and an asylum for the insane,” British ambassador Sir Auckland Geddes noted in 1923.

Milton Foster, the British journalist who described the facility’s frenzied pace in 1915, added that it was “a general hospital for all nations.” Historical accounts indicate that the doctors and nurses who worked there had to be prepared for a multitude of problems, including some they had never seen.

The new exhibit displays examples of turn-of-the-century technology, including a bronchoscope, eyedropper, syringe, laryngoscope, ear speculum and nasal speculum; there is an old bedpan, forceps used to deliver infants, an examining table, plus other tools.

Most of the new arrivals were quickly checked and approved; the process in some cases took as little as six seconds. Those who appeared sick or were thought to be mentally ill were set aside to be examined by public health physicians. Inspectors were looking for signs of diseases like tuberculosis and diphtheria, but also treated a range of more common ailments, including scalp and skin infections.

All told, only 2% of those immigrants who came to Ellis Island were denied entry, according to federal statistics.

The hospital’s busy pace subsided as the number of immigrants at Ellis Island began to decline after World War I. Congress, reacting to a backlash against immigration, passed laws in 1921 and 1924 mandating stiff quotas for various groups.

Then as now, immigration sparked a bitter national debate. But Ellis Island, which today draws more than 2 million visitors every year, is a place that celebrates those who left their homes and crossed the ocean to begin new lives in the U.S.

Once they were cleared for entry, immigrants got on ferries that took them either to the southern tip of Manhattan or to destinations in New Jersey, where they boarded passenger trains to exotic-sounding states like Illinois and California.

“So we all went down and got on the ferry boat,” said Donald Robert, a Welsh immigrant who came to Ellis Island in 1923, recalling his first moments in America, in an oral history. “And then we walked off -- just like letting birds out of the cage.”

josh.getlin@latimes.com