Ellis Island was the first federal immigration station as well as the largest formal gateway into America for the massive influx of European and Mediterranean immigrants that came throughout first half of the 20th century. In fact, over 40 percent of all living Americans can trace their roots to some ancestor who came this way. That’s not surprising, as an astounding 12 million people entered the United States between 1892 and 1954 through Ellis Island, with the immigration peaking in 1907–a year that saw approximately 1.25 million immigrants processed.

But how could they possibly manage 2-5,000 immigrants in one day – what was the actual process?

The first and second-class passengers’ immigration inspection

Following a 10 day-voyage, an immigrant steamship would dock in Manhattan. The first and second-class passengers were not required to undergo processing at Ellis Island. They were inspected aboard the ship instead due to the presumption that a person who could afford a more expensive ticket would be less likely to become a burden on the state.

The steerage passengers’ immigration inspection on Ellis Island

Steerage passengers, on the other hand, were transferred by a ferry to Ellis Island for inspection, which consisted of two parts: medical and legal.

Medical exam

The most-feared part of the inspection was the health check. Upon entering the building, the immigrants would mount the stairs leading to the second-floor. The doctors waiting at the top would secretly check the breathing, posture, gait, and general physical fitness of the people as they made the climb. The stairs took on a special meaning for many, as those suffering from sickness could be marked for rejection at that point in the process. Some even called the stairs a “medical treadmill.” In a process that lasted a mere six seconds, doctors had to decide who was healthy and who exhibited signs of sickness, marking the latter with a piece of chalk. The majority of those found unhealthy were send to the Island’s hospital, where most eventually recovered before being allowed entry into the country. Contagious diseases had to be stopped, however, so people diagnosed with them were not allowed to enter. The only physical test administered upon arrival was an eye exam for trachoma–a contagious bacterial infection that was untreatable at the time. The dreaded exam was highly unpleasant–it was performed with a button hook!

Legal inspection

After a fast medical exam came the legal inspection. People were directed to the Great Hall, where they waited to talk to the officials. Even though the inspection itself was typically brief, immigrants had to wait for several anxiety-filled hours. Each person had an inspection card (with the identifying information and processing numbers) pinned to his or her coat and had to fill out a form with up to 30 questions; steamship companies were responsible for administering the the questioner before boarding a ship. Since the rejected immigrates had to travel back, steamship companies had a financial interest in pre-screening the passengers. After a long wait in the Great Hall, the new arrivals were called one by one (or family by family) to face a legal inspector. As a rule the inspector would just ask several questions (rarely the whole set), checking the answers against the already completed document. If the answers lined up, the process would take just a few minutes, ending the ordeal. But if some discrepancies were found, people had to be detained for further inquiry. Approximately one out of ten people had to go through a special inquiry. Since most new arrivals did not speak English, interpreters were provided for speakers of each language. The essential purpose of the legal inspection was to weed out criminals as well as people who’d likely become public charge. Every entrant needed to be healthy and ready for work. The types of questions asked were:

• Where are going to live?
• Will you be staying with anyone?
• How much money are you bringing?
• Have you been to prison?
• Are you a polygamist?

It’s hard to imagine the heartbreak for those refused entry and forced to take the long journey home. Because of this, Ellis Island earned a monicker of Island of Tears. Even though each individual case of rejection must have been a tragedy, only two percent of the arriving immigrants were excluded from entry. Half of the rejections occurred due to medical issues while half were caused by legal problems–with the most common issues being contagious disease, criminal background, or insanity.